Why they can’t breathe

A new oxygen plant for the St. Francis Referral Hospital in Ifakara/Tanzania

Flashback: March 2020. The first Corona wave reaches Switzerland. The authorities are alarmed. Especially with regard to the equipment of Swiss hospitals in terms of ventilators. In a coordinated procurement action led by the army, 900 new devices are ordered at short notice from Swiss suppliers. Production is being ramped up. Hospitals are being upgraded.

That’s how it works in a country where there is little shortage.

Ifakara, Tanzania: Dr. Winfried Gingo, director of the St. Francis Referral Hospital (SFRH), has observed an increase in patients with respiratory distress. The hospital in rural Tanzania is unable to provide oxygen to patients. A few oxy-gen cylinders are available. But these have to be refilled in Dar es Salaam, some 400 km away. A lengthy and costly day’s journey, in a situation where every minute counts for the patients.

This is the reality in a country that lacks many things.

Tanzania chose a risky strategy with regard to the Covid-19 pandemic. Then-President John Magufuli doubted the existence of the virus, claimed that the country had been able to defeat the virus through prayers. Testing was not allowed.

There are no official statistics on Corona cases and victims. Magufuli knew: the population is young and the country depends on tourism. The health system would be unable to systematically treat people for the disease anyway. A hard lockdown would destroy tourism, the informal sector and the livelihood of farmers. Religion and political pragmatism: this is Magufuli’s suicidal recipe. On March 17, 2021, the president probably succumbed to the virus himself. The official version is cardiac arrest. That, for sure, is true. In March 2021, the R. Geigy Foundation of the Swiss Tropical and Public Health Institute (Swiss TPH) in Basel swiftly financed a new oxygen plant for the St. Francis Hospital. The oxygen cylinders no longer have to be driven to Dar es Salaam, but can be refilled on the spot. The facility not only supplies oxygen to the hospital, but also to all health centers and dispensaries in the region. “A massive improvement in therapy for all those infected with covid, as well as for all

others suffering from chronic lung and respiratory diseases,” says Dr. Gingo.

A glimmer of hope at the political level, too. The new president, Samia Suluhu Hassan, is taking a different approach to the virus than her predecessor. “Samia-spring”, people

say. President, Samia Suluhu Hassan, a Muslim, declares the virus exists; she wears a mask at public appearances. And she also enacts a mask requirement for public administra-

tion as well as for health personnel.

But how can the population now be convinced of the existence of Covid-19, after the old and thoroughly popular President Magufuli had preached the opposite for months? Few Tanzanians wear masks on the streets, in markets or at home. “People don’t believe in the virus,” Dr. Gingo says. Most people stay at home when they have SARS-COV-2. They don’t come to the hospital until they can barely breathe. Dr. Gingo sees little hope in terms of a possible vaccine too. The new president is also taking a new course here, encouraging all Tanzanians to get vaccinated. The government has joined the international Covax initiative. On July 24, 2021,

the country received one million vaccine doses from Johnson & Johnson, financed by the US government.

While there is already talk of a third booster vaccination in the U.S. and Europe, the vaccination campaign in Tanzania is just getting underway. Dr. Gingo doesn’t see this global disparity as a problem. “The problem is more that less educated Tanzanians are skeptical about vaccination. If only a few Africans get vaccinated, Africa could become the continent where the virus survives. And from where the virus travels around the globe in new, highly contagious variants.”

15. / 16. März 2020

Erster bestätigter COVID-19-Fall in Tansania (unterschiedliche Angaben)

6. April 2020

22 bestätigte Infektionen (nach WHO). Davon war eine Person verstorben. Laut der Website Worldometers gab es zwei genesene Patienten.

29. April 2020

Schliessung des einzigen Testlabors des Landes. Leitende Virologin des Landes wird entlassen.

7. Mai 2020

509 bestätigte Fälle, davon 21 Tote und 183 Genesene. Seither wurden keine weiteren Infektionen, Tote und Genesene mehr gemeldet.

8. Juni 2020

Präsident Magufuli erklärt das Land für frei von COVID-19. Nach seinen Angaben sei dies Gott zu verdanken.

1. Februar 2021

Die tansanische Gesundheitsministerin erklärt, dass die Regierung nicht die Absicht habe, COVID-19-Impfungen in Tansania durchzuführen. Meldungen von COVID-19-Fällen beispielsweise aus Schulen werden als ‹Falschmeldungen› wenig später wieder zurückgezogen. Im Land finden danach nur wenige Tests statt und das Thema wird von offiziellen Stellen totgeschwiegen.

5. Februar 2021

Vertreter des Gesundheitsministeriums empfehlen das Tragen von Atemschutzmasken, um sich vor ‹Atemwegserkrankungen, einschliesslich Tuberkulose› zu schützen.

17. März 2021

Präsident John Magufuli erliegt einer Krankheit. Offiziell wird als Todesursache eine Herzerkrankung angegeben, es kursieren Gerüchte, dass der Präsident selbst an COVID-19 verstorben sei.

19. März 2021

Nach dem Tod von Präsident Magufuli übernimmt die bisherige Vizepräsidentin Samia Suluhu Hassan das Präsidentenamt. Eine vorsichtige Wende in der COVID-19-Politik folgt. Die Präsidentin gibt zu, dass das Virus in Tansania zirkuliert und ruft die Bevölkerung zu Präventionsmassnahmen (Händewaschen, Masken, soziale Distanzierung) auf.

Tansania bewirbt sich offiziell um Aufnahme in das COVAX-Programm und die Regierung kündigt an, künftig Coronavirus-Fallzahlen zu veröffentlichen, was allerdings bis zum Juli 2021 nicht geschieht.

27. Juli 2021

Die Präsidentin lässt sich öffentlich und medienwirksam gegen das Coronavirus impfen. Bis hierhin hat das 58-Millionen-Einwohner-Land Tansania im Rahmen des COVAX-Programms eine Million Impfdosen des Johnson & Johnson-Impfstoffs Ad26.COV2.S über das COVAX-Programm erhalten.

Ende Juli 2021

Die von der WHO veröffentlichten Fallzahlen zeigen einen sprunghaften starken Anstieg der Infektionen.

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